Tier 1 Pharmacy Copayment Medication List Update for 2026
Summary
The Department of Veterans Affairs has published its annual update to the Tier 1 Medication Copay List, which is effective January 1, 2026, and will remain in effect until December 31, 2026. The list identifies multi-source medications that qualify for Tier 1 copay status under 38 CFR 17.110, including medications across 14 condition categories such as diabetes, heart health, mental health, and arthritis. Veterans and VA healthcare providers can access the full list at www.va.gov/resources/va-tier-1-copay-medication-list.
“Not less than once per year, VA will identify a subset of multi-source medications as Tier 1 medications.”
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What changed
VA has updated its Tier 1 Medication Copay List per 38 CFR 17.110, replacing the prior year's list with an updated compilation of multi-source medications identified through the regulatory process. The 2026 list remains effective through December 31, 2026.
Veterans and VA healthcare providers should review the updated list to confirm whether current medications remain classified as Tier 1. VA medical centers should direct patients to the published list on VA.gov for reference during medication consultations. No new compliance obligations are created by this notice.
Archived snapshot
Apr 23, 2026GovPing captured this document from the original source. If the source has since changed or been removed, this is the text as it existed at that time.
Notice
Tiered Pharmacy Copayments for Medications; Calendar Year 2026 Update
A Notice by the Veterans Affairs Department on 04/23/2026
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- Public Inspection Published Document: 2026-07880 (91 FR 21874) Document Headings ###### Department of Veterans Affairs
- [Docket No. VA-2026-VACO-0001]
AGENCY:
Department of Veterans Affairs.
ACTION:
Notice.
SUMMARY:
This Department of Veterans Affairs (VA) Notice updates the information on Tier 1 Medications.
FOR FURTHER INFORMATION CONTACT:
Tamara Wagner, Management Analyst, Office of Finance/Revenue Operations, Veterans Health Administration, (970) 242-0731, extension 2219.
SUPPLEMENTARY INFORMATION:
Section 17.110 of title 38, Code of Federal Regulations (CFR), governs copayments for medications that VA provides to veterans. Section 17.110 provides the methodologies for establishing the copayment amount for each 30-day or less supply of medication provided by VA on an outpatient basis (other than medication administered during treatment).
Tier 1 medication means a multi-source medication that has been identified using the process described in paragraph (b)(2) of § 17.110. Not less than once per year, VA will identify a subset of multi-source medications as Tier 1 medications. Only medications that meet all the criteria in 38 CFR 17.110(b)(2)(i), (ii), and (iii) will be eligible to be considered Tier 1 medications, and only those medications that meet all the criteria in paragraph (b)(2)(i) of this section will be assessed using the criteria in paragraphs (b)(2)(ii) and (iii).
Based on the methodologies set forth in § 17.110, this notice updates the list of Tier 1 medications for Calendar Year 2026. The Tier 1 medication list is posted on VA's website at the following link: www.va.gov/resources/va-tier-1-copay-medication-list.
The following table is the Tier 1 Copay Medication List that is effective January 1, 2026, and will remain in effect until December 31, 2026.
| Condition | VA product name |
|---|---|
| Arthritis and Pain | Aspirin buffered tablet, Aspirin chewable tablet, Aspirin enteric coated tablet, Allopurinol tablet, Celecoxib capsule, Diclofenac tablet, Ibuprofen tablet, Meloxicam tablet, Naproxen tablet. |
| Blood Thinners and Platelet Inhibitors | Clopidogrel Bisulfate tablet. |
| Cholesterol | Atorvastatin tablet, Ezetimibe tablet, Fenofibrate capsule or tablet, Pravastatin tablet, Rosuvastatin Calcium (CA) tablet, Simvastatin tablet. |
| Dementia | Donepezil tablet. |
| Diabetes | Glipizide tablet, Metformin Hydrochloride (HCL) tablet, Metformin HCL 24-hour Sustained Action (SA) tablet, Pioglitazone HCL tablet. |
| Electrolyte Supplement | Potassium SA tablet, Potassium SA dispersible tablet. |
| Gastrointestinal Health | Famotidine tablet, Omeprazole Enteric-Coated (EC) capsule, Pantoprazole Sodium capsule, Psyllium (regular and sugar-free) bulk powder. |
| Glaucoma and Eye Care | Carboxymethylcellulose Sodium Ophthalmic Solution, Brimonidine 0.2% ophthalmic solution, Diclofenac ophthalmic solution, Latanoprost (excludes preservative-free) 0.005% Ophthalmic solution, Polyethylene Glycol Ophthalmic solution. |
| Heart Health and Blood Pressure | Amiodarone tablet, Amlodipine tablet, Aspirin (see Arthritis & Pain), Atenolol tablet, Carvedilol tablet, Chlorthalidone tablet, Clonidine tablet, Diltiazem 24-hour capsule, Diltiazem HCL tablet, Furosemide tablet, Hydralazine HCL tablet, Hydrochlorothiazide tablet/capsule, Hydrochlorothiazide/Lisinopril tablet, Hydrochlorothiazide/Triamterene tab/cap, Isosorbide Mononitrate SA tablet, Lisinopril tablet, Losartan tablet, Metoprolol Succinate SA tablet, Metoprolol Tartrate tablet, Nifedipine SA capsule, Nitroglycerin sublingual tablet, Prazosin HCL capsule, Spironolactone tablet, Valsartan tablet. |
| Hormones/Other | None. |
| Mental Health | Amitriptyline HCL tablet, Buspirone HCL tablet, Bupropion HCL tablet, Bupropion HCL SA (12 hour-SR) tablet, Bupropion HCL SA (24 hour-XL) tablet, Citalopram Hydrobromide tablet, Duloxetine HCL EC capsule, Escitalopram Oxalate tablet, Fluoxetine tablet/capsule, Memantine tablet, Mirtazapine tablet, Paroxetine tablet, Quetiapine Immediate release (IR) Tablet, Sertraline HCL tablet, Trazodone tablet, Venlafaxine HCL IR tablet, Venlafaxine HCL SA capsule. |
| Neurologic Disorders | Ropinirole tablet. |
| Respiratory Condition | Montelukast Sodium tablet. |
| Seizures | Gabapentin capsule, Lamotrigine tablet, Topiramate tablet. |
| Thyroid Conditions | Levothyroxine Sodium tablet. |
| Urologic (Bladder and Prostate) Health | Doxazosin Mesylate tablet, Finasteride tablet, Oxybutynin Chloride SA tablet, Sildenafil tablet, Tadalafil tablet, Tamsulosin HCL capsule, Terazosin HCL capsule. |
(Authority: 38 U.S.C. 501; 38 CFR 17.110(b)(3))
Signing Authority: Douglas A. Collins, Secretary of Veterans Affairs, approved this document on April 16, 2026, and authorized the undersigned to sign and submit the document to the Office of the Federal Register for publication electronically as an official document of the Department of Veterans Affairs.
Gabriela DeCuir,
Alternate Federal Register Liaison Officer, Department of Veterans Affairs.
[FR Doc. 2026-07880 Filed 4-22-26; 8:45 am]
BILLING CODE 8320-01-P
Published Document: 2026-07880 (91 FR 21874)
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